Mar 21, 2020 1:00 AM

US military's role in response to virus outbreak is growing

Posted Mar 21, 2020 1:00 AM

WASHINGTON (AP) — The Pentagon’s role in responding to the coronavirus outbreak in the United States began to rapidly expand Wednesday as officials announced that two Navy hospital ships and two Army field hospitals were preparing to deploy to help overburdened regions.

The latest moves are aimed at taking the pressure off local hospitals so that they can free up rooms and staff to deal with virus patients. Military hospital ships and field units are geared toward treating trauma cases.

The military moves, however, face limits. It will take as long as two weeks for the USS Comfort hospital ship to get to New York City, where the governor has been pressing for medical help.

And there are logistical and legal concerns about expanding the military’s role in civilian affairs, such as tasking it with enforcing quarantines. Defense officials also want to be careful not to do anything to weaken its ability to defend the nation.

A look at the military’s role in the crisis:

WHAT THE MILITARY IS DOING

The hospital ships are not on their way but are gathering staff and preparing to go.

The USS Mercy hospital ship, which is based on the West Coast, will be ready to move out “in days,” according to officials, and the USS Comfort is undergoing maintenance in Norfolk, Virginia, and will head to New York City within two weeks.

Navy officials are trying to expedite the Comfort’s departure. It was not yet clear where the Mercy will go, but it will be somewhere on the West Coast.

Air Force Brig. Gen. Paul Friedrichs, the surgeon for the Joint Chiefs of Staff, said the plan is to staff the ships with the typical mix of medical expertise, which primarily involves trauma treatment. The ships will take non-COVID-19 patients, easing the trauma treatment load on civilian hospitals.

He said staffing decisions will be based on what local leaders need and will mainly involve active-duty military personnel.

The Army, meanwhile, is preparing to deploy two field hospitals, according to Army Secretary Ryan McCarthy. One defense official said the two field hospitals will go to New York City and Seattle, two cities with the greatest need.

The official spoke on condition of anonymity to discuss details not yet made public.

Friedrichs said Army field hospitals will be able to provide about 1,000 beds. He said they have not put reserve medical units on alert because of concerns about taking those people out of the civilian jobs in the health care industry.

Defense Secretary Mark Esper said Wednesday that 1 million respiratory masks were immediately made available to the Department of Health and Human Services, and 4 million more will follow. The Pentagon also will provide to civilian agencies as many as 2,000 special-purpose military ventilators, he said.

Also, Army scientists are researching and testing vaccines for the coronavirus, in coordination with civilian agencies. On Tuesday, Esper visited Fort Detrick in Maryland, where the research is underway.

In addition, the Pentagon continues to provide housing at four military bases for some passengers taken from the Grand Princess cruise ship, which was hit with a cluster of coronavirus cases. It also has made available housing at other bases for people entering the U.S. at certain civilian airports and needing monitoring.

The most extensive role for the military so far is for the National Guard, which is being called up by governors to provide a range of support. At least 2,000 National Guard members in 23 states are working on virus support and response. Some are helping at state emergency operations centers; others are providing transportation for civilian health care providers; and some are collecting and delivering test samples.

WHAT THE MILITARY IS CONSIDERING

There are many more ways the military could assist in the COVID-19 crisis, and Pentagon leaders said those discussions are going on continually with federal and state officials.

Friedrichs told reporters Monday that defense officials are trying to identify “what’s within the realm of the possible,” while also spelling out what the trade-offs for that would be.

For example, Friedrichs said, officials are wary to mobilize large numbers of National Guard members because it would take them away from their civilian jobs, which in some cases are in health services already engaged in fighting COVID-19.

Esper has said he is considering activating National Guard and Reserve units for federal duty to help states with planning, logistics and medical support “as needed.” Such a move would need approval by President Donald Trump.

WHAT THE MILITARY COULD DO IN AN EXTREME EMERGENCY

The Defense Department has a detailed pandemic response plan that lays out the myriad things the military can do if requested, including a last-resort role in helping to impose quarantines and border restrictions.

The military could be called on to help establish “mass casualty” treatment sites, provide shelter for displaced persons and help provide postal, power, water and sewer services, food deliveries and mortuary tasks. Troops also could provide logistics, communications and other support for law enforcement and the National Guard. Drafted and overhauled several times in recent years, the military’s plan is closely guarded and officials decline to discuss details publicly.

Officials, however, say that there is a broad assumption that local law enforcement, border control officers and the National Guard under the governors’ command would be the first line of defense to stem the spread of any virus through travel restrictions at the borders and along state lines or outbreak areas.

IMPACT ON THE MILITARY

So far, 49 members of the military have tested positive for the virus, along with 14 Defense Department civilians, 19 military dependents and seven contractors.

For most people, the new coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia.

The vast majority of people recover from the new virus. According to the World Health Organization, people with mild illness recover in about two weeks, while those with more severe illness may take three to six weeks to recover. Worldwide, more than 200,000 cases have been confirmed, while more than 8,500 people have died.

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Mar 21, 2020 1:00 AM
UPDATE: What Kansans need to know about the COVID-19 coronavirus
Health officials say one way to stop the spread of the new coronavirus is to wash your hands for at least 20 seconds. Celia Llopis-Jepsen / Kansas News Service

Kansas News Service

The new coronavirus is spreading quickly around the world, including across Kansas, and setting off a range of responses.

The Kansas News Service is boiling down key developments in the state and updating the status regularly here. To read this information in Spanish, go here. This list was last updated at 2:10 p.m. March 31.

CASES AND DEATHS

430 cases, including two from out of state (see map for counties)

9 deaths (4 in Wyandotte County, 3 in Johnson County, 1 each in Sedgwick and Crawford counties)

NOTE: These figures only include cases confirmed with lab tests and do not represent the real, unknown total. Community transmission is occurring in parts of Kansas.

STATEWIDE ORDER TO STAY HOME

Gov. Laura Kelly is instituting a statewide stay-at-home order as of 12:01 a.m. March 30. It will last until at least April 19. Stay-at-home orders allow people to take care of essential activities (such as grocery shopping or going to work) as well as exercise outside, but otherwise keep to themselves. 

The state’s stay-at-home order supersedes at least 13 county-by-county orders. Should the state’s order lift before a county’s is through, the county can choose to keep its own in effect.

SHOULD I SELF-QUARANTINE?

For the whole state: The Kansas Department of Health and Environment (KDHE) is now mandating home quarantine for 14 days if you've traveled to the places listed below. If you come down with symptoms (such as a fever of 100.4 degrees or higher, coughing or shortness of breath) during those 14 days, contact your health care provider and explain your potential COVID-19 exposure.  

  1. Louisiana or anywhere in Colorado on or after March 27.
  2. States with known widespread community transmission (California, Florida, New York and Washington) on or after March 15.
  3. Illinois or New Jersey on or after March 23.
  4. Eagle, Summit, Pitkin and Gunnison counties in Colorado (if your visit was March 8th or later).
  5. Cruise ships or river cruises on or after March 15. Anyone previously told to quarantine because of their cruise ship travel should also finish out their quarantine.
  6. International destinations on or after March 15. Anyone previously told to quarantine because of their international travel should also finish out their quarantine.

TESTING AVAILABILITY

As of March 27, Kansas health secretary Lee Norman said the state lab was handling 175 samples a day. But Kansas will receive more equipment within about a week that will let it handle 700 to 1,000 samples daily, though shortages of specialized supplies such as nose swabs may still hamper work at times. 

Norman said there’s enough capacity in the state, now that testing has ramped up through commercial labs and hospitals. State testing is reserved for high-risk groups, such as sick nursing home residents and health care workers. Others can ask their doctor or nurse practitioner to order through private labs.

What Kansas still lacks is enough testing material to study COVID-19 rates among people without symptoms.

KANSAS HAS DECLARED A STATE OF EMERGENCY. WHAT DOES THAT MEAN?

It gives the state government more power to marshal resources and triggers the state's response plan. The state Legislature has extended Kelly's declaration through May (and can extend it), with the aim of giving her the ability to make certain decisions when lawmakers aren’t in session.

On March 22, Kelly eased state rules to expand the use of telemedicine, to temporarily license more health workers and to allow heavier trucks on Kansas highways hauling relief supplies. On March 23, she ordered a ban on evictions if a tenant was unable to pay because of the coronavirus crisis. And she extended the income tax filing deadline to July 15, in line with a delay for filing federal tax forms.

HOW ARE UNIVERSITIES RESPONDING?

K-State, University of Kansas and Wichita State: All of them will go fully online for the end of the school year. Students at K-State and KU will need special exemptions to remain in dorms.

Other colleges: Washburn and Fort Hays State are online. Newman University expanded spring break for two weeks (March 14 to March 29). Johnson County Community College will close campus from March 14-29, and all courses will restart online March 30. Pittsburg State started break a day early and will resume classes indefinitely online on March 30.

HOW ABOUT K-12 SCHOOLS?

Gov. Laura Kelly and Kansas Education Commissioner Randy Watson have shut down all K-12 schools, public, private and parochial, for the rest of the 2019-20 school year. They had initially issued a strong recommendation that schools close March 16 through 20. 

Some county health departments had already issued similar orders. 

A Kansas State Department of Education task force has issued guidance to school districts on how to continue some amount of student learning. 

WHAT’S BEEN CANCELED OR SUSPENDED?

The governor’s executive order temporarily banning landlords from evicting businesses or residential tenants is effective until May 1. That same order put in a moratorium on any mortgage foreclosures through the same period.

The governor mandated on March 23, through an executive order, that gatherings be restricted to less than 10 people.

Kansas state workers: Access to the Statehouse is limited to official business only, and lawmakers went on break early. Kelly wanted most state employees to stay home for at least two weeks starting March 23.

State prisons: The Kansas Department of Corrections ended visitation at all state facilities, and will “re-evaluate on an ongoing basis.” It urges families to talk to inmates through email, phone calls and video visits. 

Electric companies: Evergy, which serves 950,000 customers in Kansas, will not disconnect residential or business services for an unspecified amount of time due to the “unprecedented challenge” of coronavirus that “may result in customers facing unexpected or unusual financial strain.”

Casinos: All four state-owned gaming facilities will close at the end of business on March 17, and remain so until at least March 30.

Public events: Many events and public places around the state have been canceled until at least the end of March. 

Sports: The Kansas State High School Athletics Association canceled the state basketball tournament midway through it. And the Big 12 suspended spring sports until March 29.  

HOW BAD IS THE VIRUS? 

COVID-19 usually causes mild to moderate symptoms, like a fever or cough. Most people with mild symptoms recover in two weeks. More severe cases, found in older adults and people with health issues, can have up to six weeks’ recovery time or can lead to death.

HOW CAN YOU AVOID IT?

  1. Wash your hands for at least 20 seconds. Frequently.
  2. Cover your coughs.
  3. If you’re an older Kansan or medically fragile, put off any vacations and limit your trips to the grocery store or any public space.
  4. Stay home if you are sick — this goes for all ages.

FOR MORE INFORMATION ON COVID-19

Kansas Department of Health and Environment: http://www.kdheks.gov/coronavirus/

The Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-nCoV/index.html

The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.